Tzu Chi Medical Journal
Volume 22, Issue 2 , Pages 96-102, June 2010

Treatment Results and Prognostic Factors for Locally Advanced Buccal Cancer

  • Feng-Chun Hsu

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Tze-Ta Huang

      Affiliations

    • Department of Oral and Maxillofacial Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Wen-Yen Chiou

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Ching-Chih Lee

      Affiliations

    • Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Moon-Sing Lee

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Shih-Hsuan Hsiao

      Affiliations

    • Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Hon-Yi Lin

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Yu-Chieh Su

      Affiliations

    • Department of Hematological Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Shih-Kai Hung

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, 2, Ming-Sheng Road, Dalin, Chiayi, Taiwan

Received 8 March 2010; received in revised form 25 March 2010; accepted 6 April 2010.

Abstract 

Objective

The aim of this study was to retrospectively analyze locally advanced buccal cancer in order to determine tumor characteristics and any other prognostic factors that may influence the survival of patients with the disease.

Patients and Methods

The records of 54 patients with stage III to IV locally advanced buccal cancer (TNM system) who were seen from August 2000 to June 2008 at one institution were reviewed. The patients received radical surgery and then adjuvant treatment. The adjuvant treatment in cluded concurrent chemoradiotherapy or radiotherapy alone. The chemotherapy protocol consisted of two 4-weekly courses of concurrent cisplatin and 5-fluorouracil followed by another two 4-weekly courses after radiotherapy, with regimens of cisplatin (60–100 mg/m2/day) on day 1 and 5-fluorouracil (1000 mg/m2/day) on days 1–5.

Results

The 3-year cumulative overall survival, disease-specific survival, disease-free survival, locoregional control, and distant metastasis-free survival rates were 66%, 69%, 58%, 65%, and 92%, respectively. Univariate analysis indicated that the pN classification, the surgical margin, and the presence of extracapsular spread were significantly associated with overall survival. On multivariate analysis, pN classification and surgical margin significantly affected disease-free survival. The pN classification (pN0 vs. pN1–3) and the surgical margin (< 1 vs.≥ 1 mm) were the two most significant factors affecting clinical outcome.

Conclusion

The presence of lymph node involvement, the presence of extracapsular spread and a surgical margin < 1 mm were strong prognostic factors that were associated with tumor control. More aggressive postoperative therapy is suggested for patients with buccal mucosa carcinoma if these factors exist.

Keywords:  Buccal cancer , Concurrent chemoradiation , Prognostic factors

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PII: S1016-3190(10)60048-1

doi:10.1016/S1016-3190(10)60048-1

Tzu Chi Medical Journal
Volume 22, Issue 2 , Pages 96-102, June 2010

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